Permit CITY OF TIGARD PLUMBING PERMIT
It • COMMUNITY DEVELOPMENT Permit#: PLM2015-00336
T IGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/06/2015
Parcel: 1 S 136C B04400
Jurisdiction: TIGARD
Site address: 8500 SW SPRUCE ST
Project: Japanese International Baptist Church Subdivision: WEST PORTLAND HEIGHTS Lot: M
Project Description: Site utilities for construction of a new multipurpose building including classrooms and a gym:(4)catch basins,(1)
manhole,(4)rain drain connectors,60 ft.of sanitary sewer,560 ft.of storm sewer,and 30 ft.of water service.
Contractor: BROCKWAY CONSTRUCTION INC Owner: JAPANESE INTERNATIONAL BAPTIST C
10875 SW HERMAN RD 8500 SW SPRUCE ST
TUALATIN, OR 97062 PORTLAND, OR 97223
PHONE: 503-968-3118 PHONE:
FAX:
FEES
Quantity Description Date Amount
4 ea Catch Basin or Area Drain 10/06/2015 $75.04
Specifics: 1 ea Manholes 10/06/2015 $18.76
4 ea Rain Drain Connector 10/06/2015 $75.04
Type of Use: COM 60 If Sanitary Sewer 10/06/2015 $62.54
Class of Work: ALT 560 If Storm Sewer 10/06/2015 $250.14
Type of Const: 30 If Water Service 10/06/2015 $62.54
Occupancy Grp: 1 12%State Surcharge- 10/06/2015 $65.29
Stories: Plumbing
Total $609.35
Required Items and Reports(Conditions)
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This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the projec.
Approved plans are required on the job site at the time of each inspection.
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Plumbing Permit Application
Site Utilities � FOR OF FR E l SE O\I.1
City of Tigard Received Permit No.:
• 13125 SW Hall Blvd.,Tig cf: 41 Da teBy: I �iI/ -�rs-
;� Plan Review
Phone: 503.718.2439 F 60 61.0 Date/By: Other Permit No.:Qti P��1 S-ev I 1
Inspection Line: 503.639.41 5 Date Ready/By: Juris: El See Page 2 for Wr d�
T I U A K u Internet: www.tigard-or.gov �G� `C�`GP�pN Notified/Method: 3, Supplemental Information
TYPE OF W• ' ON-Q�V J FEE* SCHEDULE
KAiew construction (t' 1 lttolliition For s•ecial in ormation use check list
• Description Qty. Ea. Total
El Addition/alteration/replacement ❑Other: New 1-2-family dwellings(includes 100 ft.for each utility connection)
CATEGORY OF CONSTRUCTION SFR(1)bath 312.70
1 i.1-and 2-family dwelling Commercial/industrial SFR(2)bath 437.78
/
SFR(3)bath 500.32
❑Accessory building ❑Multi-family
Each additional bath/kitchen 25.02
❑Master builder El Other:
sq.ft.) Page 2
JOB SITE INFORMATION AND LOCATION Site utilities:
Job site address: r i S ix ace__ -. = • - or area drain 4- 18.76 7S Ot(
-7-11 1414 O f „ �-j 2 Drywell,leach line,or trench drain 18.76
City/State/ZIP:
r Footing drain(no.linear ft.: ) Page 2
Suite/bldg./apt.no.: I Project name: J 'Bo_ Manufactured home utilities 50.03
Cross street/directions to job site: Manholes 1 18.76 g7.-7(„,
Rain drain connector iffa. 18.76 7S. 0 y
Sanitary sewer(no.linear ft.: ) tel t Page 2 6,2-y-L(
Storm sewer(no.linear ft.:_) 54,01 Page 2 2Y6_ i'f
Water service(no.linear ft (2 j.: ) 3O / Page 2 -111
Subdivision:
Tax map/parcel no.:
Lot no.: Fixture or item:
Backflow preventer 31.27
DESCRIPTION OF WORK Backwater valve 12.51
Clothes washer 25.02
Si U��� eJ New �yY1.C ✓f Dishwasher 25.02
Drinking fountain 25.02
Ejectors/sump 25.02
❑ PROPERTY OWNER I ❑ TENANT Expansion tank 12.51
Name: el Fixture/sewer cap 25.02
Address: �C 5(0 s P� Floor drain floor sink/hub 25.02
p'Q n Garbage disposal 25.02
City/State/ZIP: Ti !Y 1? 7/ Q t _ ''72 Z "Z---- Hose bib 25.02
Phone:( ) Fax:( ) Ice maker 12.51
❑ APPLICANT ❑ CONTACT PERSON Interceptor/grease trap 25.02
C Medical gas(value:$ ) Page 2
Business name: 1/5- --
Contact name:
IL of
��OO Primer 12.51
�� �� ��� Roof drain(commercial) 12.51
Address: /087_5 s' ikK ,9sA) 0 Sink/basin/lavatory 25.02
City/State/ZIP: jL_j-1£r`J) ( D d Solar units(potable water) 62.54
Phone:643) g�8 3/ig Fax::(5 42)e7‘8 --d7 Tub/shower/shower pan 12.51
E-mail: �� . C t CO /14 Urinal 25.02
CONTRACTOR Water closet 25.02
Water heater 37.52
Business name: C S.-"" ( Water piping/DWV 56.29
Address: Other: 25.02
City/State/ZIP: 5/C� Subtotal P f �(p
Phone:( ) Fax:( ) Minimum permit fee: $72.50
CCB Lic.: 3 Ra Plumbing Lic.no.: Plan review (25%of permit fee)
State surcharge(12%of permit fee) 65;rt 1
Authorized signa TOTAL PERMIT FEE/6I )5.----i-' -
Print name: �o/�%y���K// 9� Date:/rD -6 •-�C' This permit application expires if a cc pte is not o obtained within radd nay
��_ after it has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
I:\Building\Pennits\PLMU-PennitApp,doc 10/01/09 440-4616T(10/02/COM/WEB)
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Plumbing Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities Qty. Fee(ea) Total Square Footage: Permit Fee:
Footing drain-1st 100' 50.03 0 to 2,000 $121.90
Footing drain-each additional 100' 37.52 2,001 to 3,600 $169.69
3,601 to 7,200 $233.20
Sewer-1st 100' 62.54 (0,457( 7,201 and greater $327.54
Sewer-each additional 100' 37.52
Water Service-1st 100' 62.54 6) s-y Medical Gas Systems:
Water Service-each additional 100' 37.52
Valuation: Permit Fee:
-
Storm&Rain Drain-1st 100' 62.54 (o),,511 $1.00 to$5,000.00 Minimum fee$72.50
Storm&Rain Drain-each additional 100' S' 37.52 (g^, $5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and$1.52 for
Other Inspections or Fees Qty. Fee(ea) Total each additional$100.00 or fraction thereof,to
and including$10,000.00.
Inspection of existing plumbing or for $10,001.00 to$25,000.00 $148.50 for the first$10,000.00 and$1.54 for
which no fee is specifically indicated 90.00/hr each additional$100.00 or fraction thereof,to
(minimum charge-1/2 hour) and including$25,000.00.
Inspections outside of normal business 90.00/hr $25,001.00 to$50,000.00 $379.50 for the first$25,000.00 and$1.45 for
hours(minimum charge-2 hours) each additional$100.00 or fraction thereof,to
Reinspection Fees 90.00/hr and including$50,000.00.
Additional plan review for revisions 90.00/hr $50,001.00 and up $742.00 for the first$50,000.00 and$1.20 for
(minimum charge-1/2 hour) each additional$100.00 or fraction thereof.
Subtotal:
Commercial Fixture Work:
Are you capping,adding or replacing fixtures? If"yes",
please indicate work performed by fixture. Failure to
accurately report fixtures could result in increased sewer fees*.
Quantity by Fixture Type Plan Review for Plumbing Installations
Fixture Type for Replace/
Work Performed: Capped Added Relocate Plan review is required for any of the following.
Baptistry/Font Please check all that apply.
Bath -Tub/Shower ❑ Any new commercial building with water service 2"and
Jacuzzi/Whirlpool greater,except systems designed and stamped by licensed
Car Wash -Each Stall engineer.
-Drive Thru ❑ New exterior plumbing site utilities for any complex structure
Cuspidor/Water Aspirator as defined in OAR918-780-0040.
Dishwasher -Commercial ❑ Medical gas and vacuum systems for health care facilities.
-Domestic ❑ Any multipurpose fire sprinkler system.
Drinking Fountain ❑ Any complex structure as defined in OAR918-780-0040.
Eye Wash
Floor Drain/sink -2" Submit 2 sets of plans with any of the above.
4" Isometric or Riser Diagram
Car Wash Drain ❑ Isometric or riser diagram is required for new buildings
Garbage -Domestic-non-food
Disposal -Domestic-food related that meet the qualifications above.
-Commercial-food related
-Industrial-food related
Ice Mach./Refrig.Drains
Oil Separator(Gas Station) Comments regarding fixture work:
Rec.Vehicle Dump Station
Shower -Gang
-Stall
Sink/Lav -Non-food related
-Bradley
-Commercial-food related
-Service
Swimming Pool Filter *Note: If the fixture work under this permit results in an
Washer-Clothes
Water Extractor increase of sewer EDUs,a sewer permit will be issued and
Water Closet-Toilet fees assessed for the sewer increase must be paid before the
Urinal - plumbing permit can be issued.
Other Fixtures:
I:\Building\Permits\PLMU_PermitApp.doc 2
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Site Utilities — Plumbing Permit Application
Plan Submittal Requirements
TIGARD
A plumbing permit for site utility plumbing work is required for sanitary sewer, storm sewer
and potable water systems on private property.
1. SITE PLAN and vicinity map showing the geographic location (fully dimensional, drawn
to scale) labeled with:
A. ❑ map&tax lot# ❑ project name ❑ site address ❑ suite number
❑ zoning ❑ applicant name ❑ phone number
B. North arrow.
C. Scale (architectural or engineering only).
D. Street names.
E. Building pads with project location.
2. PLUMBING PLANS -Two (2) complete sets, civil only.
All details listed below shall be incorporated into the plumbing plans:
A. Storm drainage plan showing:
1) Finish elevations throughout the developed site.
2) Grade breaks determining area serving each catch basin.
3) Location of catch basins.
4) Pipe size.
5) Type of material.
6) Slope of piping.
7) Manholes and field drains.
8) Cleanouts provided for each 100 feet or fraction thereof.
9) Roof drain laterals specifying cleanouts at each upper terminal.
10) Location of existing or proposed connection to a public sewer line.
B. Utilities plan showing:
1) Sanitary sewer line location,pipe size, type of material, slope of piping, manholes
and cleanouts provided as required for storm.
2) Size and location of domestic water piping and drainage.
3) Proposed location of connection to a public water or sanitary sewer line.
I:\Building\Permits\PLMF-PermitApp.doc 12/30/05
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
8500 SW SPRUCE ST, TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Plumbing PLM2015-00336
Inspection Type: Inspector:
399 Plumbing final Don Sylvester
Result:
PASS - NoCofO
Comments:
1 . Corrections for site utilities are complete , plumbing final approved.
Violation Summary:
Inspector Contractor